Maria Morris says people are less afraid to address the issue of gender
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More people in the South West are seeking treatment for gender identity disorders.
The South West's only gender identity clinic, at Newton Abbot in Devon, has seen a 77% increase in referrals since last year.
There have been 50 new cases this year alone, and just under half of those referred end up having surgery.
Clinic managers say that people are more aware of the issue and it is becoming more socially acceptable.
Maria Morris, manager of the Gender and Sexual Medicine Clinic, said: "Because of clinics like ourselves, people are not as scared to come out and say: 'I need your help.'"
The clinic provides psychological support for people with gender identity disorders, from diagnosis through to transition and afterwards.
Patients are referred to another region for gender reassignment surgery.
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Out of our last 12 referrals we've had seven female-to-males so its really bucked the trend
Psychotherapist Lynda Quick
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As part of the sex change process, people must spend two years living as their chosen gender.
This means living in their new role at home, at work and socially.
The clinic is one of only three specialist units in the country.
The others are in London and Sheffield but the Devon unit, which is known as The Laurels, has seen the biggest rise in referrals.
Referrals at the Charing Cross Clinic in London went up by 55% last year, while Sheffield's went up by 59%.
Another trend is that the number of women asking for help at the Devon clinic is far higher than the national average.
Psychotherapist Lynda Quick said: "I have had a few female-to-male referrals who knew it was possible to go from male to female, but not that it was possible to go from female to male.
"So there is more awareness that this is possible. Out of our last 12 referrals we've had seven female-to-males so its really bucked the trend."
The clinic is currently working on a plan to develop its services, including provision for under 18s.
Ms Quick said: "We have had requests in the past for psychological support for under 18s and we're just beginning to recognise that we actually need to be here for those people."
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